Membership Application Form

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Apply to become a member of the Working Beauceron Club!

Within thirty (30) days following the submission of this application, you will receive a letter granting you all privileges of the Association, provided no written objection has been filed with the Membership Secretary or Secretary or no prior disciplinary action by The American Kennel Club or another dog Association has been disclosed or discovered.

If an objection is filed or prior disciplinary action is disclosed or discovered, a hold will be placed on your application pending expeditious investigation and a report will be submitted within thirty (30) days to the Board of Directors by the Membership Secretary or Secretary, for appropriate action by the Board.

All membership applications must be accompanied by a signed COE and payment of membership dues which will be emailed to you for submission.

Name *

First and last name

Address *

Email *

Phone number *

Type of Membership Requested *

Individual

Joint

Junior

Foreign

If joint, please write the name of the second person requesting membership in your household.

Please list any other animal organizations you have been, or are currently, a member of. *

Have you ever been under disciplinary investigation in an animal organization before? If yes, please explain the circumstances and the outcome. *

Occupation *

Member Sponsor Name *

Do you currently own a Beauceron?

Yes

Other:

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What working activities do you participate in with your Beauceron?

I have read and understand the current WBA Constitution, Bylaws, and Breeder/Member Code of Ethics. *

Yes

I agree to accept the official means of communication for the Working Beauceron Association to be electronic. This includes but is not limited to e-mail, telephone, audio/video conference, or other electronic means approved by the Board. Electronic communication will be used for the following: meeting notifications, dues notices, minutes, newsletters and announcements. *

Yes

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